Clinical Research On The Analgesic Effect Of Electroacupuncture Preemptive Analgesia During The Perioperative Period In Thoracic Surgery

Objective: To investigate the clinical analgesic effect of electroacupuncture of the internal anesthesia points and preemptive analgesia of the Neiguan point during the perioperative period in thoracic surgery,as well as the safety in clinical treatment.Methods: 60 cases of patients with esophageal cancer that received elective radical resection under general anesthesia in the First Affiliated Hospital of Henan University of Science and Technology in October 2015 to October 2016 were selected and were randomly divided into two groups.Group E?the observation group?received electroacupuncture stimulation 30 min before anesthesia induction,and was given electroacupuncture stimulation again postoperatively;Group F?the control group?received general anesthesia management alone,and was administered Sufentanil for patient controlled intravenous analgesia?PCIA?postoperatively.The contents of the ?-endorphin??-EP?,5-hydroxy-tryptamine?5-HT?and prostaglandin E2?PGE₂?in the blood specimens were determined before electroacupuncture?T0?,as well as 2h?T₁?,12h?T₂?,24h?T₃?and 48h?T4?after surgery.The dosage of anesthetic used during the surgery was recorded with the bispectral index?BIS?maintaining the same state?between 50 and 60?.Visual analogue scale?VAS?was adopted to evaluate the pain degree of patients at T0,T₁,T₂,T₃ and T4;and the therapeutic effect rating,safety rating as well as adverse reaction at all time points were recorded.Results:1.The VAS scores in group E patients were lower than those in group F at T₁,T₂ and T₃?P<0.05?,the difference was statistically significant.The total dosage of intraoperative Remifentanil in group E was?1.83±0.56?mg,which was remarkably reduced compared with that in group F?2.54±0.62?mg?P<0.05?,the difference was statistically significant.2.The therapeutic effect rating in the two groups: Group E was superior to group F at 2h,12 h and 24 h after operation?P<0.05?,the difference was statistically significant.3.Comparison of the safety rating indicated that group E was higher than group F?P<0.05?,the difference was statistically significant.4.The contents of ?-EP in the plasma in group E patients at T₂,T₃ and T4 were notably higher than those in group F?P<0.05?,the difference was statistically significant.It could be discovered through intra-group comparison that the contents of ?-EP in group E atT₁,T₂,T₃ and T4 were increased relative to that at T0?P<0.05?,the difference was statistically significant.the contents of ?-EP in group F at T₁ was increased relative to that at T0?P<0.05?,the difference was statistically significant.5.The contents of 5-HT in the plasma in group E patients at T₁,T₂ and T₃ were markedly decreased compared with group F?P<0.05?,the difference was statistically significant.It could be discovered through intra-group comparison that the contents of 5-HT in the plasma in group F at T₁,T₂ and T₃ were distinctly increased than those at T0?P<0.05?,the difference was statistically significant;while the differences in 5-HT in group E at all time points showed no statistical significance?P>0.05?.6.The contents of PGE₂ in the plasma in group E patients at T₁,T₂ and T₃ were markedly decreased compared with group F?P<0.05?,the difference was statistically significant.It could be discovered through intra-group comparison that the contents of PGE₂ in the plasma in group F at T₁,T₂ and T₃ were distinctly increased than those at T0?P<0.05?,the difference was statistically significant;while the differences PGE₂ in group E at all time points showed no statistical significance?P>0.05?.Conclusion: Electroacupuncture preemptive analgesia could provide safe and effective postoperative analgesia for thoracic surgery and reduce the dosage of intraoperative analgesic,the possible mechanism of which might be related to the fact that electroacupuncture of the internal anesthesia points and the Neiguan point could increase the production of the endogenous ?-EP and inhibit the release of the inflammatory media 5-HT and PGE₂.